An 82 year old man with pain in neck, lower back, right knee and tingling sensation in right arm
This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.
Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.
This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome.
This is a case of an 82 year old man with pain in the neck, lower back, right knee and tingling sensation in his right arm.
History of Presenting Illness:
Patient was apparently asymptomatic 10 years ago until he developed shortness of breath of grade 2. It has been occurring intermittently over the past 10 years. No history of Orthopnea or pnd
Until 5 years ago he says he had a relatively normal life and ran his own barber business for over 60 years. About 6 years ago, he started experiencing trembling and involuntary shaking of his hands and was not able to continue his business so he stopped working and started staying at home.
2 years ago he developed pain in the right side of his neck which was radiating towards his right arm. He also developed pain in his right knee and left lower back.
Associated with morning stiffness and reduced range of movements. Pain increases on walking, climbing stairs and he is unable to sit on the floor. He has not been able to turn his head properly to the left since then. He also is unable to flex and extend his wrists
He has sought out treatment for these problems in his hometown but said they haven’t worked out so well for him.
He also has been experiencing episodic ringing sensation in his left ear since the past 2 years, at least twice in a week.
He has been experiencing giddiness too, he was not able to recall since how long but he thinks it might have been occurring since his neck,knee and lower back pains have started.
1.5 years ago he had an episode of lightheadedness and profuse sweating and chest pain. The episode subsided after 15 mins after sitting down and eating something according to the attender.
4 months back, he had another episode of chest pain radiating to his left arm, associated with shortness of breath, profuse sweating. It was not associated with nausea, vomiting, palpations. He was taken to the hospital and was given antiplatelets, anticoagulants and statins and was discharged after 8 days of conservative management.
He hasn’t been able to walk properly, sit or do his daily activities since then.
Daily Routine:
Patient wakes up at 5 AM and drinks 2 glasses of hot water. Then he freshens up and drinks tea. Prior to his heart attack, he used to go for a morning walk, but now he remains at home. He eats breakfast at 8 Am and after that he doesnt do much other than lying down. He eats lunch at 3 pm and then he takes rest. If he feels like it, he watches TV. He eats dinner at 9 pm. The patient says it takes him a long time to fall asleep and his bedtime is usually after 12 AM
Past history:
He was diagnosed with hypertension 20 years ago and has been using medication since then.
Patient used to smoke beedi from the age of 20 to 50 years. He cannot recall how many he used to smoke in a day but claims he smoked atleast a few bundles.
He used drink atleast half litre of toddy a day until 30 years ago.
Personal history:
Appetite normal
Diet mixed
Has been experiencing sleep distrbances and has used sleeping pills for years. Has stopped since 4 months
Bowel normal
Bladdder: experiencing decreased frequency of urination since 5-6 days. Flow has decreased
General examination
Patient is conscious, coherent and cooperative. Well oriented to time place and person.
Hello and welcome! My name is Bhargavi Kantipudi and i am a medical student from india. One of the most transformative experiences for medical students is patient case based learning, which offers a unique perspective in real world medical scenarios. I would like to present a selection of medical cases that i have examined. CBBLE PAJR PARTICIPATORY LEARNING ACTION RESEARCH DISCLAIMER NOTE: THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS/HER GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT We began our clinical rotations in 2nd year and in our initial days of medicine postings, I remember going to the ward a few times. I can recall a few patients, an old women with dysphasia, a man with tremors and bradykinesi
This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan. Patient came to the casualty on 17-5-23 with complaints of 1. Decreased urine output since one day 2. Loose stools 7-8 episodes since 1 day HOPI Pt was apparently asymptomatic till the previous morning, then s
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